Influence of thyroid peroxidase antibodies on TSH levels of pregnant women and maternal–fetal complications

2018 ◽  
Vol 65 (8) ◽  
pp. 444-450
Author(s):  
Paula Fernández Martínez ◽  
Rocío Aguado García ◽  
David Emilio Barajas Galindo ◽  
Ana Hernández Moreno ◽  
Mirian Alejo Ramos ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibodies ◽  
Fetal Complications ◽  
Tsh Levels

THYROID PEROXIDASE ANTIBODIES IN MEXICAN-BORN HEALTHY PREGNANT WOMEN, IN WOMEN WITH TYPE 2 OR GESTATIONAL DIABETES MELLITUS, AND IN THEIR OFFSPRING

2000 ◽  
Vol 6 (3) ◽  
pp. 244-248 ◽  
Author(s):  
Carlos Ortega-González, MD ◽  
Alexis Liao-Lo, MD ◽  
Jorge Ramírez-Peredo, MD ◽  
Norma Cariño, Biol ◽  
Josefina Lira, MD ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibodies

scholarly journals Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease

2018 ◽  
Vol 178 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Flora Veltri ◽  
Pierre Kleynen ◽  
Lidia Grabczan ◽  
Alexandra Salajan ◽  
Serge Rozenberg ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Pregnancy Outcomes ◽  
Thyroid Disease ◽  
Thyroid Autoimmunity ◽  
Thyroid Peroxidase ◽  
Normal Range ◽  
Baseline Characteristics ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveIn the recently revised guidelines on the management of thyroid dysfunction during pregnancy, treatment with thyroid hormone (LT4) is not recommended in women without thyroid autoimmunity (TAI) and TSH levels in the range 2.5–4.0 mIU/L, and in a recent study in that particular group of pregnant women, more complications were observed when a treatment with LT4 was given. The objective of the study was therefore to investigate whether variation in thyroid function within the normal (non-pregnant) range in women free of thyroid disease was associated with altered pregnancy outcomes?DesignCross-sectional data analysis of 1321 pregnant women nested within an ongoing prospective collection of pregnant women’s data in a single centre in Brussels, Belgium.MethodsThyroid peroxidase antibodies (TPO-abs), thyroid-stimulating hormone (TSH), free T4 (FT4) and ferritin levels were measured and baseline characteristics were recorded. Women taking LT4, with TAI and thyroid function outside the normal non-pregnant range were excluded. Pregnancy outcomes and baseline characteristics were correlated with all TSH and FT4 levels within the normal range and compared between two groups (TSH cut-off < and ≥2.5 mIU/L).ResultsTobacco use was associated with higher serum TSH levels (OR: 1.38; CI 95%: 1.08–1.74);P = 0.009. FT4 levels were inversely correlated with age and BMI (rho = −0.096 and −0.089;P < 0.001 and 0.001 respectively) and positively correlated with ferritin levels (rho = 0.097;P < 0.001). Postpartum haemorrhage (>500 mL) was inversely associated with serum FT4 levels (OR: 0.35; CI 95%: 0.13–0.96);P = 0.040. Also 10% of women free of thyroid disease had serum TSH levels ≥2.5 mIU/L.ConclusionsVariation in thyroid function during the first trimester within the normal (non-pregnant) range in women free of thyroid disease was not associated with altered pregnancy outcomes. These results add evidence to the recommendation against LT4 treatment in pregnant women with high normal TSH levels and without TPO antibodies.

scholarly journals Thyreotropin levels in diabetic patients on metformin treatment

2012 ◽  
Vol 167 (2) ◽  
pp. 261-265 ◽  
Author(s):  
Carlo Cappelli ◽  
Mario Rotondi ◽  
Ilenia Pirola ◽  
Barbara Agosti ◽  
Annamaria Formenti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Treatment Group ◽  
Normal Serum ◽  
Thyroid Peroxidase ◽  
Diabetic Patients ◽  
Metformin Treatment ◽  
Lowering Effect ◽  
Thyroid Peroxidase Antibodies ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveA retrospective study to evaluate the changes in TSH concentrations in diabetic patients treated or not treated with metformin and/or l-thyroxine (l-T4).MethodsThree hundred and ninety three euthyroid diabetic patients were divided into three groups on the basis of metformin and/or l-T4 treatment: Group (M−/L−), 119 subjects never treated with metformin and l-T4; Group (M+/L−), 203 subjects who started metformin treatment at recruitment; and Group (M+/L+), 71 patients on l-T4 who started metformin recruitment.ResultsThe effect of metformin on serum TSH concentrations was analyzed in relation to the basal value of TSH (below 2.5 mIU/l (Q1) or between 2.51 and 4.5 mIU/l (Q2)). In patients of group M+/L+, TSH significantly decreased independently from the basal level (Q1, from 1.45±0.53 to 1.01±1.12 mU/l (P=0.037); Q2, from 3.60±0.53 to 1.91±0.89 mU/l (P<0.0001)). In M+/L− group, the decrease in TSH was significant only in those patients with a basal high-normal serum TSH (Q2: from 3.24±0.51 to 2.27±1.28 mU/l (P=0.004)); in M−/L− patients, no significant changes in TSH levels were observed. In patients of group M+/L− showing high-normal basal TSH levels, a significant decrease in TSH was observed independently from the presence or absence of thyroid peroxidase antibodies (AbTPO; Q2 AbTPO +: from 3.38±0.48 to 1.87±1.08 mU/l (P<0.001); Q2 AbTPO −: from 3.21±0.52 to 2.34±1.31 mU/l (P<0.001)).ConclusionsThese data strengthen the known TSH-lowering effect of metformin in diabetic patients on l-T4 treatment and shows a significant reduction of TSH also in euthyroid patients with higher baseline TSH levels independently from the presence of AbTPO.

scholarly journals Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zareen Kiran ◽  
Aisha Sheikh ◽  
Najmul Islam
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Gestational Hypertension ◽  
Neonatal Outcomes ◽  
Reproductive Age ◽  
Independent Effect ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Thyroid Peroxidase Antibodies ◽  
Maternal And Neonatal Outcomes

Abstract Background Autoimmunity increases with age and is often commonly evaluated in women of the reproductive age group. Prevalence of thyroid antibodies is common even in euthyroid pregnant women. We aim to compare the association of thyroid antibody status on the maternal and neonatal outcomes in pregnant women with hypothyroidism. Methods We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital. Information was collected on pregnant women who have been diagnosed with hypothyroidism before conception or during their antenatal period. Laboratory data were recorded for thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid-stimulating hormone levels. Maternal and neonatal outcomes were also noted from medical file records. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Results Overall, 146 out 718 cases were included for final analysis. Thyroid peroxidase antibodies were positive in 66.4% and anti-thyroglobulin was positive in 52.1% cases, whereas 43.8% of cases had both antibodies positive. Pre-gestational diabetes was significantly associated with thyroid autoimmunity. There was a 73% less chance of gestational hypertension for thyroid autoimmune groups. Gestational diabetes and maternal (chronic) hypertension were found to have an independent effect on postpartum hemorrhage. Hypertensive disorders in pregnancy were found to have an independent risk for premature birth. Conclusion Our study reports a 74.7% prevalence of positive thyroid antibodies in hypothyroid pregnant women, with higher association with pre-gestational diabetes. Gestational hypertension was least likely to occur in thyroid autoimmune groups. None of the outcomes were independently associated with worse outcomes.

scholarly journals Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

2021 ◽  
Vol 8 (2) ◽  
pp. 182-187
Author(s):  
Shruthi H S ◽  
Nalini Arunkumar ◽  
Ravi N Patil
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Peroxidase ◽  
American Thyroid Association ◽  
Tertiary Care Centre ◽  
Mother And Child ◽  
Tsh Levels

: Hypothyroidism during pregnancy has an adverse effect on both mother and child. The maternal and foetal risk is higher in TPOAb (Thyroid peroxidase antibody) positive women compared to women with negative TPO Ab. The recent ATA (American Thyroid Association) guidelines recommend that pregnant women with TSH (Thyroid Stimulating Hormone) concentration above 2.5mU/L should be evaluated for TPOAb status and LT4(levothyroxine) treatment should be considered with TSH values between 2.5mU/L and 4.0mU/L only when TPOAb status is positive.: All the pregnant women booked in first trimester underwent testing for TSH levels and subsequently for anti TPO Ab if TSH levels were between 2.5-4 mIU/ml. The hospital based prevalence of women with anti TPO Ab positive status was determined. These pregnancies were followed till term and the maternal and foetal complications associated with TPO Ab positive and negative status were compared. Total of 400 pregnant women were included. The hospital prevalence of women with anti TPO antibodies in first trimester of pregnancy with TSH values between 2.5- 4 mIU/ml was found to be 23.5%. Anti TPO antibody positive status was significantly more associated with antenatal complications especially GDM and IUGR as compared to patients with anti TPO antibody negative status (47.8% v/s 23.2%, p value 0.001).: Women with TPO Ab positive status are to be vigilantly monitored for early detection and management of various antenatal complications. Determining anti TPO Ab status helps in avoiding unnecessary treatment of the women with TPO Ab negative status and TSH between 2.5-4mIU/ml.

scholarly journals Effect of thyroid peroxidase antibodies on thyroid-stimulating hormone reference limits in a primarily Latina population

2009 ◽  
Vol 2 (4) ◽  
pp. 154-156
Author(s):  
Richard H Lee ◽  
Carole A Spencer ◽  
Martin N Montoro ◽  
Paola Aghajanian ◽  
T Murphy Goodwin ◽  
...  
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Serum Samples ◽  
Reference Limit ◽  
Thyroid Peroxidase Antibodies ◽  
Reference Limits ◽  
Stimulating Hormone

The aim of the paper is to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and assess its effect on the thyroid-stimulating hormone (TSH) reference range during pregnancy in a primarily Latina population. Serum samples were collected from healthy pregnant women and non-pregnant controls. TSH reference ranges were calculated when TPOAb-positive patients were either included or excluded. A total of 134 pregnant women and 107 non-pregnant controls were recruited. Positive TPOAb titres were found in 23 (17.2%) of the 134 pregnant women, and in 14 (13.1%) of the 107 non-pregnant controls. When the TPOAb-positive women were included in the TSH analysis, the upper reference limit using two different methods was consistently higher: 0–2.2 fold in the non-pregnant women, 2.01–2.78 fold in the first trimester, 3.18–4.7 fold in the second and 1.05–1.42 fold in the third. The lower TSH reference limit was not affected by the inclusion of TPOAb-positive subjects. In conclusion, inclusion of TPOAb-positive patients results in higher upper reference limits during pregnancy.

scholarly journals Management of Thyroid Peroxidase Antibody Euthyroid Women in Pregnancy: Comparison of the American Thyroid Association and the Endocrine Society Guidelines

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
L. Mehran ◽  
M. Tohidi ◽  
F. Sarvghadi ◽  
H. Delshad ◽  
A. Amouzegar ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Autoimmunity ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibodies ◽  
American Thyroid Association ◽  
Childbearing Age ◽  
Endocrine Society ◽  
Thyroid Peroxidase Antibody ◽  
Fetal Complications ◽  
New Guidelines

The presence of thyroid autoantibodies is relatively high in women of childbearing age. There is evidence that positive thyroperoxidase antibody even in euthyroid women may increase the risk of spontaneous and recurrent pregnancy loss and preterm delivery. However, the evidence is not enough to justify recommendation on the screening of pregnant women for thyroid autoantibodies or LT4 supplementation for reducing maternal or fetal complications. In this paper we reviewed the related evidence and compared the new guidelines of the American Thyroid Association and Endocrine Society with respect to the screening and management of positive thyroperoxidase antibody in euthyroid pregnant women. As there was no major contradiction or disagreement between the two guidelines, either one of two guidelines may be used by clinicians for the appropriate management of thyroid autoimmunity during pregnancy.

Thyroid peroxidase antibodies do not predict outcome in 900 women with recurrent pregnancy loss

2017 ◽  
Author(s):  
Sofie Bliddal ◽  
Nielsen Henriette Svarre ◽  
Aase Krogh-Rasmussen ◽  
Kolte Astrid Marie ◽  
Christiansen Ole Bjarne ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibodies
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